HomeMy WebLinkAboutStreet Cut Permits 50 Bourbon Street 1700025 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 03/07/2017
GIS ID: 12300050 =
FEE- 0.00
MUNIS APPLICATION# 201700200 c EXPIRATION DATE:
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APPLICANT =r 4 LOCATION
NAME: EVERSOURCE r
ADI7RE5$ ? BOURBON STREET
ADDRESS: 112 PROSPECT HILF ROAD OWNER rIMMIR DEBRA
EAST WINDSOR,CT 0608
y50 B''OI BON STREET
5 NOUTH WINDSOR,CT 06074
PHONEM IV—
WORK DESCRIPTION: GAt SERVICE WORE 1•I;O1VICU $ INF�4OiOUSE
APPLICANT AGREES TO FURNISH THE OWN f�F 0 7 TH,Tr,D -R 1'HE 1M(DI-AfNT OF$OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR Y'V. II�ICLIREI)$Y T11E TOWl'±IFfJR 1VIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T1 iE ArPPLI��IT I�`F`A�#N1AR H A ]I3 WIf,L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN'CJF S()J PH WINDSgR'S STREET CU T`pI:RMIT MANUAL.
AP
ISSUED BY DATE"INPECTED INSPECTED BY
3/7/20 1 7 3:53PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMITri6..-L 7OWS CONTRACTOR:
LOCATION: .
TYPE OF M IK: Qe,
DATE INSP NEEDED: DATE INSP: " ?
INSPECTED BY: j�
WORK IN
PROGRESS' r r�r�'�I i�' : f4! S - vtl' -- t
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SEPTIC TANK.PUMPED,SMASHED,FILLED WITNESSED ❑YES ❑NO
AS-BUILT:
ORATE: '
s/mancy/foms lox Town of south Windsor ireseCTIoffREROU 14 "'
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of rn :P.hone No. ' -- L�'2 L�7 g'.
Address aft"irlrt �. p Code
Location.of proposed wo'r'
Describe fully nature of permit reques tl:d 1! "IE.. T'Q- 1 !1! E�."t', c�' -. cS'
!t
Starting date- : ^ / Call Before You Dig No ' 1 :
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT'PATCH AND CURB;;REPLACEMENT IS A:PRELIMINARY ESTIMATE. THE:
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND:CURB REPLACEMENT;.INCLUDING ANY
INCREASES:IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS, THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULDBE LATER THAN:A YEAR.
Check Applicable: No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Q Existing Driveway,No Changes ❑ Proposed Driveway;Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service; ❑ Public Sewer ❑ Septic
_..�._. .
Show sketch of proposed work or furnish Indicate North 'I'hfo to he#fllact autbgy�.
two copies:.of separate drawing
No,cuts.. . .
I . Est. Patch Size(s) sf
i
Est.Pvt.Thickness
Est..Patch Unit.Price$..:.......:.....:.:..:...........:._......-.:.::
I Est.Patch Cost.
i Est.Curb Replacement ft
Est,Curb Unit Price:$ /ft
Est.Curb Cosh'.....
`.;.Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ lsf
Este Sidewalk Cost-$. .
;..got..Traffic Hours.
Est:Traffic Unit Cost$ /hr
i Est.Traffic Control;
I I
Amt.of Deposit$....- —.
DRIVEWAYS must be aft or more from the property line per s Total Due..
section 2.17 of the zoning regulations
( )Cash { }Check.# .I
Applicant is responsible for contacting the-Police Dept,and C.B.Y.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
(.:AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH.
WINDSOR:FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT I AM.FAMILIAR WITH AND WILL ABIDE BY.THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S.STREET CUTPERMIT MANUAL.
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J -r";.... :,Print Nam@ �(�+ .� . t4�8 'lflt�t.._ _ Dater ....r-Z. Dl
Street Excavation Permit 2014
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